Drinking well water and occupational exposure to Herbicides is associated with chronic kidney disease, in Padavi-Sripura, Sri Lanka

Abstract

BackgroundThe chronic kidney disease of unknown etiology (CKDu) among paddy farmers in was first reported in 1994 and has now become most important public health issue in dry zone of Sri Lanka. The objective was to identify risk factors associated with the epidemic in an area with high prevalence.MethodsA case control study was carried out in Padavi-Sripura hospital in Trincomalee district. CKDu patients were defined using health ministry criteria. All confirmed cases (N = 125) fulfilling the entry criteria were recruited to the study. Control selection (N = 180) was done from people visiting the hospital for CKDu screening. Socio-demographic and data related to usage of applying pesticides and fertilizers were studied. Drinking water was also analyzed using ICP-MS and ELISA to determine the levels of metals and glyphosate.ResultsMajority of patients were farmers (N = 107, 85.6%) and were educated up to ‘Ordinary Level’ (N = 92, 73.6%). We specifically analyzed for the effect modification of, farming by sex, which showed a significantly higher risk for male farmers with OR 4.69 (95% CI 1.06-20.69) in comparison to their female counterparts. In the multivariable analysis the highest risk for CKDu was observed among participants who drank well water (OR 2.52, 95% CI 1.12-5.70) and had history of drinking water from an abandoned well (OR 5.43, 95% CI 2.88-10.26) and spray glyphosate (OR 5.12, 95% CI 2.33-11.26) as a pesticide. Water analysis showed significantly higher amount of hardness, electrical conductivity and glyphosate levels in abandoned wells. In addition Ca, Mg, Ba, Sr, Fe, Ti, V and Sr were high in abandoned wells. Surface water from reservoirs in the endemic area also showed contamination with glyphosate but at a much lower level. Glyphosate was not seen in water samples in the Colombo district.ConclusionThe current study strongly favors the hypothesis that CKDu epidemic among farmers in dry zone of Sri Lanka is associated with, history of drinking water from a well that was abandoned. In addition, it is associated with spraying glyphosate and other pesticides in paddy fields. Farmers do not use personnel protective equipments and wears scanty clothing due to heat when spraying pesticides.

Glyphosate, pathways to modern diseases IV: cancer and related pathologies

“…The study did not specify exactly to which pesticides the children were exposed, but glyphosate is a general-purpose herbicide whose use in rice paddies in Sri Lanka led to widespread kidney failure among young agricultural workers there, ultimately resulting in a ban on glyphosate usage in Sri Lanka [4,5]. While glyphosate is technically an organophosphonate rather than an organophosphate, a study on the fish Prochilodus lineatus has demonstrated that it suppresses cholinesterase in both muscle and brain [39].…”

“…agricultural workers in the northern region [4,5], and was probably further motivated by the WHO reevaluation of its carcinogenic potential. Kidney disease is a risk factor for multiple cancers, with kidney dialysis being associated with increased risk of Kaposi's sarcoma by more than 50-fold, with 3-to 10-fold increased risk of kidney cancer, and 2-to 9-fold increased risk of thyroid cancer.…”

Reverse osmosis plant maintenance and efficacy in chronic kidney disease endemic region in Sri Lanka

“…Male farmers from North-Central province (NCP) who spray glyphosate-based herbicides, drink water from shallow wells and had history of drinking from an abandoned Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura 50008, Sri Lanka well (abandoned due to increasing foul taste), are at higher risk of developing CINAC [2]. Chronic low dose exposure to multiple heavy metals and agrochemicals is hypothesized as the etiological factor for CINAC [3].…”

Water, rest, shade: Can simple actions stop an epidemic of chronic kidney disease of unknown etiology among farm workers in Central America?

“…Those crystals may injure the kidneys. However, other causal factors have been debated, such as metals and silica in the drinking water or pesticides used in farming (4,5). It is possible that the disease is multifactorial, depending on the region.…”